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Eur J Cardiothorac Surg 1999;16:499-505
© 1999 Elsevier Science NL

Total arterial coronary revascularization and factors influencing in-hospital mortality

^a Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
^b Department of Anaesthesia, The Royal Melbourne Hospital, Parkville, Victoria, Australia

Corresponding author. Suite 3, Private Medical Centre, P.O. Box 2135, Royal Melbourne Hospital, Parkville, Victoria 3050, Australia. Tel.: +61-3-9342-8908; fax: +61-3-9342-8908
e-mail: alistair.royse{at}nwhcn.org.au

Objective: To determine if arterial conduit selection or more efficient arterial revascularization techniques influence in-hospital mortality. Methods: Data from patients undergoing coronary artery bypass surgery at Royal Melbourne Hospital, Australia, between 1 January 1996 and 30 June 1998 (n = 1681) was collected prospectively. Logistic regression analysis was performed. Results: Independent preoperative predictors of increased in-hospital mortality included renal failure, redo coronary artery surgery and intra-aortic balloon pump use. In-hospital mortality for total arterial revascularization 0.7%, radial artery use 0.9%, pedicled arterial revascularization 0.2%, composite arterial conduit 0.4%, and the exclusive Y graft operation 0.3%. These were all associated with reduced in-hospital mortality. Mortality when vein graft was used was 2.9%. Most patients received total arterial revascularization, which was considered the primary surgical strategy. Conclusion: Total arterial revascularization, radial artery use and complex arterial reconstructions were associated with reduced in-hospital mortality. Preoperative renal failure, intra-aortic balloon pump use and redo coronary surgery predicted greater in-hospital mortality.

Key Words: Radial artery • Total arterial • Pedicled arterial • Y graft • Composite arterial

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